Fulltext search in archive

The complaints of white fingers in postmen who had used motorbikes and had been exposed to low intensity vibration were studied. Their vibration exposure was found to be 1-3 m/s2 per day, four hour equivalent value of frequency weighted acceleration. The rate of white fingers among all subjects was 2.8%. The rate was related not only to vibration/cold exposure but also to age and delivery area locations. The major part of the white finger occurrence reported here was considered to be due to primary Raynaud's syndrome, and it seems safe to conclude that, a daily vibration exposure of up to 2.5-3 m/s2 (4 h equivalent value) has not caused white fingers in this population.

The authors examined 120 dental technicians, 111 women, 9 men, of mean age 44.8 years, mean duration of exposure 24.9 years. Cold water test, plethysmographic investigation, and EMG (in indicated persons), X-ray, neurological and orthopedic examinations were performed. Combination of exposure to vibration above the limit value, with overload of upper extremities, was proved by hygienic measurement. The most frequent subjective complaints included vertebral complaints (52.5%), paresthesiae in the hand fingers (47.4%) and pain in the joints of upper extremities (elbow 26.6%, shoulder 10.8%, wrist 6.6% and small joints of hand 6.6%). Four workers reported history of white fingers, but the cold water test did not prove it. Deteriorated plethysmographic curve was in 11 cases only. Pathological motor conduction in nervus medianus was found (by EMG investigation) in 13 persons. Carpal tunnel syndrome was acknowledged in 4 individuals as an occupational disease. The results of these investigations show the hazard of dental technicians work and the necessity of improvement of their work conditions.

In the course of 13 months we monitored the occurrence of strains of P. mirabilis, P. vulgaris, Kl. pneumoniae, including its indole-positive variant and S. marcescens in patients of the Anaesthesiology and Intensive Care Unit (AICU) of the Teaching Hospital (TH) in Brno. Out of 436 patients hospitalized at that time, 95 (21.8%) were colonized or infected by one or all of the bacterial species studied. Out of those 95 patients, 48 (50.5%) came to the AICU already colonized or infected by one of the studied agents mostly from other wards of the TH or from other hospitals. At the AICU, 32 of them were reinfected or superinfected by one, two or all of the bacterial species studied. Of the 436 hospitalized patients, 79 (18.1%) were newly infected, reinfected or superinfected. By serotyping, proticine production and proticine sensitivity (P-S) typing and phage typing we demonstrated the endemization of some P-S types and phage types of the bacterial species studied and their spreading among the contemporaneously hospitalized patients. The endemic strains of P. mirabilis included P-S types P5/S6, S7, S9 and P5/S6, S7; P0/S9; P1/S2, S11 and P1/S11. The two biotypes of Klebsiella, i.e. K. pneumoniae and K. oxytoca, were identically sensitive to some of the phages 1, 2, 3, 8 and 106, particularly to phages 2 and 3, or 2, 3 and 106. The isolated strains of Serratia were absolutely resistant to the 26 bacteriophages used.

The authors presented 1642 cases of professional diseases caused by vibrations (VD) and 435 cases of extremity overload disease (EOD) diagnosed in the years 1974-1993. In addition to the standard rheoplethysmography there were evaluated the results of digital laser Doppler flowmetry (Moor instruments, UK) in 104 workers exposed to vibration (EV) and 25 controls with the age and smoking habit standardisation. In the selected subgroup were used continual measurements of digital blood pressure (Finapress, Ohmeda), digital LD flux and speed and the measuring of digital skin and central body temperature simultaneously. The records before and after 10 min of local cooling test (Rejsek method) and postocclusive hyperemic tests were summarized (computer evaluation, program STATGRAPHICS, T-test). Vasoconstriction to local cooling persisted in EV for longer time. The records of digital skin flux and speed, digital blood pressure reactions of EV were significantly different (EV/controls) also in the 10th min after cooling. Postocclusion hyperemic tests revealed good functional capacity also in EV. Advantages and disadvantages of methods were discussed. The results found by non-invasive methods in VD were in good relation to images obtained by means of radionuclides (clearance and cumulative tests). Cumulative tests (after 99m - pertechnetate i.v.) can be used in the selected differential diagnostic cases of angiopathies to help to distinguish degree of angiospastic and angioparalytic changes in the hands of VD, and also in special cases at angiopathies connected with EOD.

In 1991-92, a complement fixation test technique (titre > or = 8) was used in serological assays of antibodies to Coxiella burnetti performed in cattle in southern Moravia. Antibodies were ascertained in 6.1% to 213 aborting cows. The cows with a positive finding after abortion came from 13 different farms. On two of the farms (H. V. and P.), all the cattle were tested. On the H. V. farm, antibodies were ascertained in 4.2% of 120 cows, in 1 of 36 calves and in none of 93 heifers. On the P. farm, antibodies were ascertained in 14.1% of 519 cows and 15.2% of 521 cows in 1991 and 1992 respectively, in 17.4% of 190 calves and in none of 40 heifers. C. burnetii was ascertained in the milk of 9 of 15 seropositive cows from the P. farm, in all cows with the titre > or = 64. On the P. farm, reproduction characteristics of cows were monitored to ascertain possible links with the latent Q fever infection, but no relationship was found in this case. In 1991, sera of 56 employees from farms with seropositive cattle (in H. V. and P. and from another farm) and 26 employees from an industrial company were tested but the complement fixation tests failed to detect any antibodies. The C. burnetii strain circulating in south Moravian herds at present may be described as little virulent or avirulent.

The acridinium ester labelled DNA probe specific for M. avium complex (MAC) was used for testing 30 strains of MAC previously identified by conventional procedures. The hybridization was positive in 26 strains, negative in 3 strains and one strain seemed to be contaminated when subcultured. The specific DNA probes allow to identify even the slow growing mycobacterial strains, in positive samples, within two hours while conventional methods usually take several weeks to show the result. A rapid confirmation of a mycobacterial species is invaluable for selecting an effective treatment as early as possible, which is extremely important e.g. in immunosuppressed patients, children with lymphadenitis, etc. Nevertheless, this method has the disadvantage of being too expensive for some laboratories, though questionable if repeated subcultures, technician's time and the delay in obtaining results are taken into account, and enabling to identify only a limited number of clinically significant mycobacterial species using commercially available probes.

In bone samples of 181 humans decreased at the age of 0-99 years from Brno and surroundings, lead content was determined by the method of atomic absorption spectrometry. The geometrical mean of the lead content of the whole set is 2.29 micrograms.g-1 of dry tissue (min 0.26 max. 29.28 micrograms.g-1). With the age the lead content in bone gradually increases from the value of the geometric mean of 1.35 micrograms.g-1 in the first year of life to almost a double in the age decade of 21-30 years. Up to 80 years it roughly remains on a constant level, after the age of 80 it rises again up to the mean value of 4.26 micrograms.g-1. Differences between the sexes in the whole set as well as in the individual age groups are very small and non significant. Statistically significant differences in Pb content in bone were found in the relation to the size of the place of residence (P < 0.05); however, no association was proved with the character of place of residence, occupation, smoking habits or type of the underlying cause of death.

In the course of year 1991 and 1992 about 594 blood donors of the Brno agglomeration in the Czech Republic were examined for the ochratoxin A content (OA) in blood serum. When higher concentrations of OA were found the blood donors were examined repeatedly (differentiation of acute or chronic exposure). A mean concentration of 0.63 microgram OA/l blood serum (0.30 microgram = geom.mean) was recorded. The assessed continuous mean daily dietary intake of OA was about 0.74 ng (0.35 ng = geom. mean) OA/kg b.w./day. The assessed continuous mean contamination of food groups (cereal and meat products) was about 0.65 microgram (0.31 microgram = geom. mean) OA/kg. In persons with elevated OA concentrations in blood serum the decrease was at the latest confirmed within 2 months after the test result. An accidental acute exposure was probably involved. Tolerable daily intake of OA (TDI) was determined with regard to the nephrotoxic, teratogenic, immunosuppressive and carcinogenic effect at the level of: 16,500, 250 and 5 ng OA/kg b.w./day. As a legislative limit TDI = 5 ng OA/kg b.w./day was suggested. The group of persons studied was probably not threatened by any of the health risks given.

The authors analyze the effectiveness of the National Vaccination Programme with regard to poliomyelitis eradication in Bulgaria and the difficulties encountered in the 1980s and at the beginning of the 1990s. An account is presented on the eradication achieved, interrupted by an outbreak of 46 cases in 1991. The critical analysis points out the negative influence of several factors, disrupted by the failure in 1991. Based on these fact conclusions are drawn on a prolongation of the period needed to achieve the Eradication Programme goal. The main reasons for the delay are as follows: the intensive migration process, the existence of small non-immunized groups of population (gipsy population) as well as some shortcomings in the organization of the health services. According to the authors, stricter epidemiologic supervision is imperative for the country as well as coordination of similar approach to the problem in countries of the region.

The main unresolved issues concerning environmental exposure to chrysotile asbestos of the general population are discussed. A review of the results of the measurement of airborne chrysotile fibres in buildings is presented showing that the results have been consistently low with the exception of buildings with damaged friable asbestos-containing material. Quantitative risk assessments are presented indicating that the lifetime risk is small compared to many other environmental risks. Possible adverse health effects of paraoccupational exposures in the case of high domestic airborne asbestos levels cannot be excluded. Both on the basis of electron microscopy analyses of asbestos exposures at locations with heavy traffic, and the very shallow slopes in the exposure-response relationships for increased lung cancer risk, the conclusion is drawn that exposure to airborne asbestos-containing friction materials has not been proven to pose a significant health risk to the general population. Reviewing animal ingestion studies published and all the available epidemiological studies related to asbestos in drinking water, the conclusion is drawn that the carcinogenic risk in the general population is low even in the case of drinking water containing elevated concentrations of chrysotile asbestos.